FY 2015 Ryan White HIV/AIDS Program Part A
HIV Emergency Relief Grant Program
Technical Assistance Call
August 12, 2014
Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Bureau
Division of Metropolitan HIV/AIDS Programs
Speakers:
Steven Young, Director Gary Cook, Deputy Director
Michael Amoh
Keisha Johnson
Helen Rovito
Amelia Khalil
Andrea Jackson
Sera Morgan
Theresa Jumento
Agenda
Welcome
Purpose of Webinar
Program Information
Application Due Date and Award Date
Highlights of FY 2015 Funding Opportunity
Announcement (FOA)
• Section Overview
• Questions & Answers
• Program Contact Information
•
•
•
•
•
Purpose of the Webinar
The purpose of this webinar is to provide:
• Technical assistance
• General information
• Answers to questions received from all eligible
metropolitan areas relative to HRSA-15-003
Program Information
• Approximate funding for FY 2015 – $618,492,359.00
• Available to 52 grantees
• Ryan White HIV/AIDS Program (RWHAP) legislation (Sec.
2603 (a)(4)) of the Public Health Service Act hold harmless
will not be a factor in the FY 2015 Ryan White HIV/AIDS
Program Part A awards
• Information on RWHAP and the Affordable Care Act, along
with Policy Clarification Notices, can be found at
http://hab.hrsa.gov/affordablecareact/
• Information on the National HIV/AIDS Strategy (NHAS) is
located in the SF-424 Application Guide
Due and Award Dates
• Application Due Date
September 19, 2014 by 11:59 PM EST
• Project Period
March 1, 2015 – February 29, 2016
Highlights FY
2015 FOA
Highlights FY 2015 FOA
• Reorganized Needs Assessment
o New Sections:
 Impact of Affordable Care Act (ACA)
 Minority AIDS Initiative (MAI)
• Streamlined Methodology
• Modified Workplan
o New Section:
 HIV Care Continuum
Highlights FY 2015 FOA
• Clarified Evaluation and Technical Support
Capacity of Clinical Quality Management
(CQM)
• Refined Organizational Information
• Review Criteria Recalculated
Section Overview
Section Overview
Needs Assessment
Jurisdictional Profile
• Describe the population of persons with HIV/AIDS using
epidemiological data
• In section 1(1) of the jurisdictional profile, provide both HIV and
AIDS incidence and prevalence for calendar years (CY) 2011,
2012, and 2013
• Sample table below illustrates how data may be presented in the
FOA:
CY 2011
Incidence
HIV
AIDS
Prevalence
CY 2012
Incidence
Prevalence
CY 2013
Incidence
Prevalence
Section Overview
Needs Assessment
Demonstrated Need
•
5 sections: Unmet Need, Early Identification of Individuals
with HIV/AIDS (EIIHA), Unique Service Delivery Challenges,
the Minority AIDS Initiative (MAI) and Impact of Funding
•
“New/Emerging Populations”
o Include in FY 2015 FOA only if significant changes/ new communities
were noted from previous FOAs
•
Unmet Need
o Comprised of 3 sections:
 CY 2013 Unmet Need estimate (Attachment 4)
 Unmet Need trends (2011, 2012, 2013)
 Description of how Unmet Need data are considered during
planning and decision making process
Section Overview
Needs Assessment
Minority AIDS Initiative
• New section in FY1205 FOA
• Three (3) components:
1. Identify minority populations living with HIV and the
specific sub-groups
2. Describe how MAI funds were considered during the
planning process and service categories funded;
describe how services differ from Part A services
3. Describe two (2) funded MAI activities
Section Overview
Needs Assessment
Early Identification of Individuals with
HIV/AIDS (EIIHA)
1. Legislation
2. EIIHA Components
a)
b)
EIIHA Data
EIIHA FY 2015 Plan
3. EIIHA Scoring
4. FY 2013 Progress Report (not part of the
FY 2015 FOA)
Section Overview
Needs Assessment
EIIHA - Part A Legislation
• Part A Legislation Section 2602 (b)(4)(A)(B)(C)(D):
o “…shall determine size and demographics of the estimated
population of individuals with HIV/AIDS who are unaware of their HIV
status”
o “determine the needs of…individuals with HIV/AIDS who do not know
their HIV status”
o “develop a comprehensive plan…that includes – “
 “a strategy, coordinated as appropriate with other community
strategies and efforts, including discrete goals, a timetable, and
appropriate funding, for identifying individuals with HIV/AIDS who
do not know their HIV status, making such individuals aware of
such status, and enabling such individuals to use the health and
support services”
Section Overview
Needs Assessment
EIIHA Components
• EIIHA for FY 2015 will have 2 components:
1. EIIHA Data
2. FY 2015 EIIHA Plan
Section Overview
Needs Assessment
EIIHA
• Select 3 target populations from FY 2014 EIIHA
Plan
• Provide data from January 1, 2014 – June 30, 2014
(or most recent 6-month period)
• Definitions are outlined in the FOA
• Data collection, analysis, usage
Section Overview
Needs Assessment
EIIHA
•
•
•
Describe the planned activities for FY 2015
Include all populations for the EIIHA Plan
Describe how the overall FY 2015 EIIHA Plan contributes to
the NHAS and White House Continuum of Care Initiative
o
•
Link: http://www.whitehouse.gov/the-pressoffice/2013/07/15/executive-order- hiv-care-continuum-initiative.
Describe how the EIIHA Plan for FY 2014 influenced the
development of the plan for FY 2015
Section Overview
Needs Assessment
EIIHA
• Select target populations for FY 2015 (may be
previously described populations)
• Describe plans to present, discuss, and/or
disseminate the EIIHA Plan and outcomes of your
plan activities to stakeholders (e.g., poster
presentations, journal articles, presentations to
planning bodies)
Section Overview
Needs Assessment
EIIHA Scoring
• EIIHA section will be scored the same as in
past FOAs
o 33 points total
 EIIHA Data – 14 points
 EIIHA FY 2015 plan – 19 points
Section Overview
Needs Assessment
EIIHA Reporting Dates
Funding Opportunity
Announcements
Progress Reports
Progress
report due
date
FY 2015 FOA
EIIHA Data – January 1-June 30,
2014
FY 2015 Progress Report
EIIHA Data – January 1December 31, 2014
2016
FY 2014 FOA
EIIHA Data-January 1-June 30,
2013
FY 2014 Progress Report
EIIHA Data-January 1-December
31, 2013
July 30, 2015
FY 2013 FOA
EIIHA Data-Partial 2012
FY 2013 Progress Report
January –December 2012
July 30, 2014
Section Overview
Needs Assessment
Impact of Funding
• Expanded section in FY15 FOA
• Impact of the Affordable Care Act
1.
2.
3.
4.
5.
Uninsured and poverty
Impact of insurance expansion
Outreach and enrollment
Marketplace options
Successes/Outcomes
Section Overview
Needs Assessment
Impact of Funding
• Impact and response to reduction in Ryan White
HIV/AIDS Program formula funding
• Impact of co-morbidities on the cost and
complexity of providing care
• Coordination of services and funding streams
Section Overview
Needs Assessment
Section Overview
Section Overview
Letter of Concurrence
Planning councils (PC) and planning bodies (PB)
must respond to the following:
1.FY 2014 formula, supplemental and MAI funds are being
expended in keeping with PC or PB priorities
2.All Conditions of Award relative to the PC or PB have been
addressed
3.Priorities were established by PC or PB in keeping with
approved processes
4.Annual PC or PB training took place – include dates
5.PC or PB membership is reflective of the EMA/TGA
** Include plan and timeline for addressing each vacancy
Section Overview
Community Input Process
Community Input Process
• Description of priority setting and
resource allocation process
(PSRA)
See a-j, pg. 19
• How data from Part A and other
Federal programs was used
during the PSRA processes
• How these data may be linked to
future health outcomes
Section Overview
Section Overview
Workplan
U.S. HIV Care Continuum
Source: http://aids.gov/federal-resources/policies/care-continuum/
Section Overview
Workplan
HIV Care Continuum
• Provide a graph which depicts the RWHAP Part A
HIV Care Continuum in the EMA/TGA
o Include baseline data for CY 2013 or the most recent
calendar year for each stage of the HIV Care Continuum
o Use Ryan White Services Report (RSR) data or any available
data as a baseline for Ryan White HIV/AIDS Program-eligible
individuals
o Clearly cite data sets used
o Clearly describe the numerator and denominator
Section Overview
Workplan
HIV Care Continuum
Narrative which addresses how the HIV Care
Continuum will be used in:
• Planning, prioritizing, targeting and monitoring resources
• Reducing health disparities
• Reducing challenges and barriers around data sharing
and collaboration with local, state and Federal partners
Section Overview
Workplan
Implementation Plan
• Two components:
o Service Category Table
o HIV Care Continuum Table
• Both sections are included as Attachment 9
Section Overview
Workplan
Attachment 9
Section Overview
Workplan
Section Overview
Workplan
SAMPLE FORM
Ryan White Part A Implementation Plan: HIV Care Continuum
Grantee Name:
Big City EMA
Fiscal Year: 2015
Stages of the HIV Care HIV Care Continuum
Continuum
Goal
I. Diagnosed
Increase in the percentage of
clients who are aware of their
HIV Status
II. Linked to Care
III. Retained in Care
IV. Prescribed ART
V. Virally Suppressed
Increase in the percentage of
clients linked to care
Increase in the percentage of
clients retained in care
Increase in the percentage of
clients with access to prescribed
HIV/AIDS medications consistent
with PHS Treatment Guidelines
Increase in the percentage of
clients with a viral load of <200
Outcome
Service Category (One
or more may apply)
HIV Positivity*
Late HIV Diagnosis*
Early Intervention Services
Baseline: Numerator/Dominator, %
Target: Numerator/Dominator, %
7/10
9/10 90%
70%
Linkage to HIV Medical Care*
Outpatient Medical Care
Medical Case Management
Medical Transportation
Baseline: Numerator/Dominator, %
Target: Numerator/Dominator, %
67/100
87/100
67%
87%
Retention in HIV Medical Care*
HIV Medical Visit Frequency**
Outpatient Medical Care
Medical Case Management
Medical Transportation
Baseline: Numerator/Dominator, %
Target: Numerator/Dominator, %
58/100
72/100
58%
72%
Antiretroviral Therapy (ART) Among Persons in HIV Medical Care*
Prescription of HIV Antiretroviral Therapy **
Baseline: Numerator/Dominator, %
Target: Numerator/Dominator, %
76/100
92/100 92%
76%
Viral Load Suppression Among Persons in HIV Medical Care*
HIV Viral Load Suppression**
Baseline%:
45/100
Target: Numerator/Dominator, %
45%
80/100
80%
* HHS Measures can be found at http://www.aids.gov/pdf/hhs-common-hiv-indicators.pdf
** HAB Core performance measures can be found at: http://hab.hrsa.gov/deliverhivaidscare/coremeasures.pdf
Outpatient Medical Care
Medical Case Management
Medical Transportation
Outpatient Medical Care
Medical Case Management
Medical Transportation
Treatment Adherence
Counseling
Section Overview
Resolution of Challenges
• Discuss challenges
encountered in
integrating the HIV Care
Continuum into the
planning and
implementation of your
Part A program
• Describe approaches
used to resolve these
challenges
Section Overview
Section Overview
Organizational Information
• Grantee Administration
• Grantee Accountability
o Program Oversight
o Fiscal Oversight
• 3rd Party Reimbursement
• Maintenance of Effort
• Budget and Budget Justification Narrative
Section Overview
Organizational Information
Budget Justification Narrative – Attachment 12
•Specific, detailed justifications for all allocated items in the
program-specific line item budget
•Clearly state how each object class category’s efforts
and/or activities make a contributing impact to support the
Part A HIV service delivery system
•Applicants are strongly encouraged to use the suggested
template, Budget Justification Narrative (Attachment 12), to
respond to the Budget Justification Narrative section of the
FOA. A sample of the suggested template is attached and
will be available for download during the webinar
Section Overview
Organizational Information
Budget Narrative
1)Description of how the amounts requested for line item in the budget will support the
achievement of the proposed objectives
2) Clearly explain how each activity impacts the Part A HIV service delivery system
Under the Personnel Object Class Category, all costs must
include the name, position title, and FTE allotment.
Section Overview
Organizational Information
Cost Categories - Salary Limitations Requirement
(Appropriations Act 2013)
Salaries charged to
Individual’s base
HHS grants may not
salary, exclusive of
Applies to
exceed $181,500
fringe benefits and
subcontracts
annually
outside income earned
Section Overview
Section Overview
Evaluation and Technical Support Capacity
Clinical Quality Management
• CQM section has four components:
1.
2.
3.
4.
CQM Infrastructure
CQM Program Performance Measures
CQM Program Quality Improvement
Data for Program Reporting
Review Criteria
Review Criteria
Criterion
Points
Subsets
1. Need
67
Jurisdictional Profile: 7
Demonstrated Need: 7
EIIHA : 33
Unique Service Delivery Challenges: 2
MAI: 6
Impact of Funding: 12
2. Response
15
Planning & Resource Allocation: 6
Care Continuum and Implementation Plan:
8
Resolution of Challenges: 1
3. CQM
5
Infrastructure, Performance measurement
& QI: 5
4. Resources/
Capabilities
10
Program Organization: 2
Program Accountability: 8
5. Support Requested
3
Budget and MOE: 3
1
Review Criteria
Review Criteria
C1: Need
2014 FOA
34
2015 FOA
67
Includes EIIHA
C2: Response
C3: Evaluative Measures
13
5
15
5
C4: Resources/Capabilities
10
10
C5: Support Requested
5
3
33
100
N/A
100
C6: EIIHA
TOTAL
Review Criteria
EIIHA
• Worth 33 points by legislative mandate
• Focus on 3 targeted populations
• Data (a-g) = 14 points
** Use January 1 – June 30 data**
• EIIHA Plan = 19 points
Review Criteria
New Items:
Impact of the Affordable Care Act – 4 points
Minority AIDS Initiative – 6 points
HIV Care Continuum and Implementation Plan – 8 points
Items NOT Scored:
HIV Care Continuum Table
Applicants will not be penalized for not having access to the
most recently requested data
Reporting Requirements
Reporting Requirements
FY 2014 Part A Grant Requirements Calendar
FY 2013 Requirements
Contents
Submission
Due to EHB
July 30, 2014
Requirement Type
FY 2013 Annual Progress Report
Annual Progress Report Format & WICY
Table
FY 2013 Final FFR and Carry Over
July 30, 2014
Condition
FY 2013 Part A & MAI Expenditure Table
July 30, 2014
Reporting Requirement
Final FY 2013 MAI Annual Report
for period 3/1/2013 to 2/28/2014
January 31, 2015
Reporting Requirement
FY 2014 Requirements
Contents
Requirement Type
FY 2014 Program Term Report
REVISED: SF 424A, Budget Narrative,
Implementation Plan, CLC, CRC, & FY 2014
Part A & MAI Planned Allocation Table,
Planning Council Roster, LPAP Profile (new)
(Send Planning Council Co Chairs signed
letter endorsing the allocations and
program priorities)
Final FY 2014 MAI Annual Plan for the use of
the Part A MAI funds for period 3/1/2014 to
2/28/2015
UOB Estimates and Estimated Carryover
Ryan White Services Data Report (RSR)
Submission
Due to EHB
August 15, 2014
July 18, 2014
Reporting Requirement
December 31, 2014
March 30, 2015
Reporting Requirement
Reporting Requirement
FY 2014 Final FFR and Carry Over
July 30, 2015
Condition
FY 2014 Part A & MAI Final Expenditure
Table
Final FY 2014 Part A Annual Progress Report
& Expenditure for WICY (see NOA for
additional details)
FY 2014 MAI Annual Report
July 30, 2015
Reporting Requirement
July 30, 2015
Reporting Requirement
January 31, 2016
Reporting Requirement
Federal Financial Report, FFR
(SF 425)
FY 2013 Part A & MAI FINAL
Expenditure Report
Final FY 2013 MAI Annual
Report
Final FY 2014 MAI Annual Plan
Unobligated Balances (UOB)
Ryan White Services Data
Report (RSR)
Federal Financial Report, FFR
(SF 425)
FY 2014 Part A & MAI Final
Expenditure Table
Final FY 2014 Part A Annual
Progress Report
MAI Annual Report
Reporting Requirement
Reporting Requirement
Questions & Answers
Program Contacts
HAB/DMHAP Contact
Steven R. Young, MSPH
Director, Division of Metropolitan HIV/AIDS Programs
5600 Fishers Lane, 09W03
Rockville, Maryland 20857
Email: Syoung@hrsa.gov
Telephone: (301) 443-6745
Fax: (301) 443-8143
Please continue to submit specific questions through your assigned Project Officer. These
will be combined with others with answers posted and circulated to all eligible areas.
Technical Assistance Website: http://www.careacttarget.org